To verify a member's plan, please either log in or register. Our goal is to help you quickly and easily find out if you, the provider, or a provider referral, participate in the member's plan.
*Blue Shield of California Member Plans Only
Guidelines and Standards
In This Section
Find policies and announcements about medications, treatments and other topics related to our medication policy.
Read an explanation of HIPAA, including Blue Shield's commitment to protecting the privacy of patient medical records.
Review the AB1455 regulations approved by the Department of Managed Healthcare, Blue Shield's regulations summary and a compliance overview.
Access Blue Shield's policy on medical record standards, and generic forms to assist providers with documentation requirements.
How Blue Shield makes utilization management decisions.
Access preventive health guidelines for healthy children, adolescents and adults. Included are immunizations, health screenings and more.
Blue Shield recommendations for evaluating common acute and chronic conditions such as asthma, diabetes and depression.
Blue Shield's policy for sharing and disclosing private member data.
How providers continue participation in the Blue Shield network, including a recredentialing application and mailing instructions.
Frequently asked questions about the National Provider Identifier, the unique number assigned to all healthcare providers to facilitate transactions.
Resources on hospital and facility guidelines, updates and announcements.
View a list of Other Payors (employers, insurance companies, associations, etc.) with which Blue Shield holds contracts.